Systems and Methods for Surgical Implant Guidance and Positioning with Optical Surface Imaging

ABSTRACT

Described here are systems and methods for positioning a surgical implant, such as a glenoid component, or other medical device intra-operatively. In general, the systems and methods described in the present disclosure implement a computer vision system, which may be a structured light computer vision system, together with a suitable optical tracker as an accurate intra-operative tool for predicting post-operative implant position in surgical procedures.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional PatentApplication Ser. No. 62/728,256, filed on Sep. 7, 2018, and entitled“SYSTEMS AND METHODS FOR SURGICAL IMPLANT GUIDANCE AND POSITIONING WITHOPTICAL SURFACE IMAGING,” which is herein incorporated by reference inits entirety.

BACKGROUND

Glenoid component position is an important factor for postoperativefunction and long-term implant survival in both anatomic and reversetotal shoulder arthroplasty. For instance, glenoid component positioneffects shoulder motion, impingement points, and stresses at thebone-prosthesis interface. Glenoid component failure is one of the mostcommon complications of total shoulder arthroplasty, and malposition ofthe glenoid component has been associated with instability, implant,loosening, early failure, and inferior clinical outcomes.

Achieving adequate alignment and stable fixation of the glenoidcomponent can be technically challenging. Restricted visualization,limited bony landmarks, and the complex and variable scapular geometrymake glenoid component placement a relatively blind procedure. Abnormalglenoid morphology and bone loss is common in primary and revisionprocedures, which further complicates positioning the baseplate alongthe anatomic centerline and achieving stable fixation.

Current orthopedic intra-operative imaging systems generally includetwo-dimensional (2D) and three-dimensional (3D) C-arm x-ray fluoroscopyand cone beam CT systems. Two-dimensional x-ray images do notcharacterize the 3D position of the glenoid component with sufficientaccuracy. Intra-operative 3D x-ray imaging systems present a logisticalchallenge and are unwieldy for imaging the shoulder of a patient in thestandard beach chair position for shoulder arthroplasty. Thus, thereremains a need to provide means for verifying the position of theglenoid component intra-operatively.

SUMMARY OF THE DISCLOSURE

The present disclosure addresses the aforementioned drawbacks byproviding methods for guiding a placement of a surgical implant orsurgical tool. The methods include providing to a computer system, oneor more pre-operative images that depict a patient and an anatomicalregion-of-interest in the patient; generating with the computer system,a model of the anatomical ROI from the one or more pre-operative images;acquiring an image of the patient when an optical tracker is arranged ona landmark in the anatomical ROI using an imaging system, wherein theimage of the patient depicts at least one of a position or anorientation of the optical tracker relative to the anatomical ROI;generating registered data with the computer system by registering theimage of the patient with at least one of the one or more pre-operativeimages and the model of the anatomical ROI; and displaying theregistered data on a display, wherein the registered data comprises avisual depiction of the optical tracker relative to the anatomical ROIin order to provide visual guidance to a user of a placement of asurgical implant or surgical tool relative to the anatomical ROI.

It is another aspect of the present disclosure to provide an opticaltracker comprising a base composed of a biocompatible material andextending from a proximal surface to a distal surface along a centralaxis; and a channel formed in the base and extending from the proximalsurface of the base to the distal surface of the base along the centralaxis, wherein channel is sized and shaped to receive one of a guide pinor a guidewire.

It is another aspect of the present disclosure to provide a kitcomprising an optical tracker and a reorientation tool. The opticaltracker comprising a base composed of a biocompatible material andextending from a proximal surface to a distal surface along a centralaxis; and a channel formed in the base and extending from the proximalsurface of the base to the distal surface of the base along the centralaxis, wherein channel is sized and shaped to receive one of a guide pinor a guidewire. The reorientation tool comprising a fiducial partcomprising an annular base having a central aperture in which a notch isformed; a key part sized and shaped to be received by the centralaperture of the fiducial part, the key part comprising an annular basehaving a central aperture, wherein a catch is formed on an outer surfaceof the annular base of the key part, wherein the catch is sized andshaped to operative engage the notch formed in the central aperture ofthe fiducial part; and one or more interchangeable insert parts, eachinsert part comprising a cylindrical base that is sized and shaped to bereceived by the central aperture of the key part, wherein each insertpart comprises at least one channel that defines a trajectory having aunique polar angle, wherein each insert part is rotatable within thecentral aperture of the key part to define a unique azimuthal angle.

The foregoing and other aspects and advantages of the present disclosurewill appear from the following description. In the description,reference is made to the accompanying drawings that form a part hereof,and in which there is shown by way of illustration a preferredembodiment. This embodiment does not necessarily represent the fullscope of the invention, however, and reference is therefore made to theclaims and herein for interpreting the scope of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A and 1B show an example of an optical tracker that can beimplemented with the systems and methods described in the presentdisclosure.

FIGS. 2A and 2B show an example of a reorientation tool that can beimplemented with the systems and methods described in the presentdisclosure.

FIGS. 3A and 3B show a fiducial part that forms a part of thereorientation tool shown in FIGS. 2A and 2B.

FIGS. 4A and 4B show a key part that forms a part of the reorientationtool shown in FIGS. 2A and 2B.

FIGS. 5A and 5B show an interchangeable insert part that forms a part ofthe reorientation tool shown in FIGS. 2A and 2B.

FIG. 6 illustrates a flowchart setting forth the steps of an examplemethod for providing surgical guidance using the systems described inthe present disclosure.

FIG. 7 is a block diagram of an example system that can implement themethods described in the present disclosure.

FIG. 8 is a block diagram of example hardware that can implement thesystem of FIG. 7.

DETAILED DESCRIPTION

Described here are systems and methods for positioning a surgicalimplant, such as a glenoid component, or other medical deviceintra-operatively. In general, the systems and methods described in thepresent disclosure implement a computer vision system, which may be astructured light computer vision system, together with a suitableoptical tracker as an accurate intra-operative tool for predictingpost-operative implant position in surgical procedures.

As stated, the systems and methods described in the present disclosureenable a surgical guidance system that can be used for accurateplacement of a surgical implant. The systems and methods described inthe present disclosure can also enable a surgical guidance system thatcan be used for accurate placement of other implantable medical devices,or for the accurate positioning of a surgical instrument.

The implant or surgical instrument position is generally defined by astart point and trajectory of a guide pin, guidewire, or other landmark,from which the remaining surgical steps proceed. The systems and methodsdescribed in the present disclosure provide an intra-operative surgicalguidance system that implements an imaging system, such as a structuredlight sensor and computer vision algorithms, to verify the position ofthe surgical implant, implantable medical device, or surgical instrumentintra-operatively. Once validated, the systems and methods described inthe present disclosure can intra-operatively detect instances where theguide pin, guidewire, or other landmark, is malpositioned, enablingsurgeons to re-position it prior to preparation and implantation of thesurgical implant, or prior to the administration of a therapeutic agentor effect using a surgical instrument.

Referring now to FIGS. 1A and 1B, an example of an optical tracker 10that can be used for accurate guidance and positioning of a surgicalimplant or other implantable medical device is illustrated. The opticaltracker 10 includes a channel 12 extending from a proximal surface 14 toa distal surface 16 of the optical tracker 10 along a central axis 18 ofthe optical tracker 10. The channel 12 is sized and shaped to receive aguide, which may be a guide wire, a guide pin on a surface of thesurgical implant or other medical device to be tracked by the opticaltracker 10, or another suitable structure that facilitates guidance ofthe placement, positioning, or both, of a surgical implant or othermedical device. As one example, the channel 12 can have a circular crosssection that is sized to receive a guide wire or a guide pin on aglenoid component of a shoulder implant.

The optical tracker 10 is preferably radially symmetric about itscentral axis 18. Having this radial symmetry reduces thedegrees-of-freedom needed for registering images of the optical tracker10. It will be appreciated by those skilled in the art that the opticaltracker 10 does not need to be radially symmetric.

In some embodiments, the optical tracker 10 is shaped such that aleading surface of the optical tracker 10 is chamfered, beveled, orotherwise includes a region where the outer extent of the opticaltracker 10 is reduced. As one non-limiting example, the proximal surface14 of the optical tracker 10 can be chamfered such that the outerdiameter of the optical tracker 10 reduces from a first outer diameterto a second outer diameter at the proximal end of the optical tracker 10that is smaller than the first outer diameter.

As one non-limiting example, the optical tracker 10 can be a radiallysymmetric annular structure having an outer diameter of 12 mm and achannel 12 having an inner diameter of 3.2 mm, which is sized to receivea Steinman pin used for a central glenoid guide pin.

The optical tracker 10 is generally composed of a biocompatiblematerial. For instance, the optical tracker 10 can be machined orotherwise manufactured from a medical grade polymer, such as medicalgrade polyether ether ketone (PEEK) meeting the ISO 10993-5 standard forbiocompatibility.

In some embodiments, the optical tracker 10 is composed of abiocompatible material that is also sterilizable, such that the opticaltracker 10 can be sterilized after use and used again in a differentprocedure. For instance, the optical tracker 10 can be composed of abiocompatible material that can be sterilized using a steam autoclave orother suitable sterilization process. In some embodiments, the opticaltracker 10 can be made to be disposable.

The optical tracker 10 is colored or otherwise designed to be visible toan imaging system, such as an optical surface imaging system. As oneexample, an optical surface imaging system can include a structuredlight imaging system. As one example, the optical tracker 10 can becolored such that the optical tracker 10 has sufficient contrastrelative to tissues, surgical instruments, and other objects that may bepresent in the surgical field (e.g., gloves covering a surgeon's hand).As one non-limiting example, for applications where the optical tracker10 is imaged with a structured light imaging system, the optical tracker10 can be colored as blue or gray.

As described, the optical tracker 10 is generally constructed to bevisible to one or more particular imaging systems. In some instances,the optical tracker 10 can be designed for use with a structured lightimaging system. In other instances, the optical tracker 10 can bedesigned to be visible with other medical imaging modalities, includingx-ray imaging and magnetic resonance imaging.

Referring now to FIGS. 2A and 2B, an example of a reorientation tool 20that can be used to facilitate reorientation of the surgical implant, orother implantable medical device, is shown. The reorientation tool 20generally includes a fiducial part 30, a key part 40, and an insert part50. Like the optical tracker 10, the reorientation tool 20 and itsconstituent parts may be composed of a biocompatible material. In someinstances, one or more of the constituent parts of the reorientationtool 20 may be designed to have unique visualization properties tofacilitate visualization of the reorientation tool 20 and itsconstituent parts in one or more images. For instance, the fiducial part30 can be composed of a material that is colored to be visible in imagesacquired with a structured light imaging system, and with sufficientcontrast relative to the surgical field, the surgical implant, theoptical tracker, or combinations thereof.

As shown in FIGS. 3A and 3B, the fiducial part 30 of the reorientationtool 20 generally includes an annular base 32 having a central aperture34 that is sized and shaped to receive the key part 40 of thereorientation tool 20. As shown, the central aperture 34 can have agenerally circular cross section; however, the central aperture 34 canalso have different cross sectional shapes. The central aperture 34 canhave a notch 36 formed therein.

As shown in FIGS. 4A and 4B, the key part 40 of the reorientation tool20 generally includes an annular base 42 having a central aperture 44that is sized and shaped to receive the insert part 50. As shown, thecentral aperture 44 can have a generally circular cross section. Theouter surface 46 of the annular base 42 has a catch 48 formed thereon,which is sized and shaped to be received by the notch 36 on the fiducialpart 30 when the key part 40 is arranged within the fiducial part 30.Interlocking the catch 48 and notch 36 prevents the key part 40 fromrotating within the central aperture 34 of the fiducial part 30.

As shown in FIGS. 5A and 5B, the insert part 50 of the reorientationtool 20 generally includes a base 52 that is sized and shaped to bereceived by the central aperture 44 of the key part 40. The base 52 hasformed therein one or more channels 54 that correspond to differenttrajectories for the guide pin, guidewire, or other landmark, that canbe used for guidance of the surgical implant. The different channels 54therefore define trajectories with different polar angles. The base 52is rotatable within the central aperture 44 of the key part 40, therebyallowing for the adjustment of the azimuthal angle of the trajectoriesdefined by the one or more channels 54. Different insert parts 50 can beconstructed to define different trajectories, such that the insert part50 can be interchanged during the surgical procedure to achieve thedesired trajectory for the surgical implant or other medical device.

Having described an example of an optical tracker and reorientationtool, methods for providing surgical guidance to a user during asurgical procedure using the systems described in the present disclosureare now described.

Referring now to FIG. 6, a flowchart is illustrated as setting forth thesteps of an example method for providing guidance in the positioning ofa surgical implant using the systems described in the presentdisclosure.

The method includes providing pre-operative images of the patient to acomputer system, as indicated at step 602. The pre-operative images canbe images acquired with an x-ray imaging system, which may include acomputed tomography (“CT”) imaging system, images acquired with amagnetic resonance imaging (“MRI”) system, images acquired with othersuitable medical imaging systems, or combinations thereof. Thepre-operative images can be provided to the computer system by accessingor otherwise retrieving previously acquired images from a memory orother suitable data storage, or can include acquiring the images with amedical imaging system and communicating the images from the medicalimaging system to the computer system.

A model of the anatomical region-of-interest (e.g., the region where thesurgical implant will be placed) is generated from the pre-operativeimages, as indicated at step 604. Alternatively, the model can be apreviously generated model that is provided to the computer system. Themodel may be, for example, a three-dimensional model of the anatomicalregion-of-interest. In some instances, the model can include a model ofone or more anatomical structures in the anatomical region-of-interest.As one non-limiting example, the model can be of a patient's scapula.

During placement of the surgical implant, or other medical device, aguidewire is typically used to provide guidance and accurate positioningof the surgical implant or other medical device. An optical tracker,such as those described in the present disclosure, can be positionedover such a guidewire, as indicated at step 606. Alternatively, theoptical tracker can be positioned on a guide pin or other suitablestructure on the surgical implant or medical device.

When the surgical implant is in place with the optical tracker, an imageof the surgical field is then obtained, as indicated at step 608. As oneexample, the image of the surgical field can be obtained using astructured light imaging system. Alternatively, other imaging systemscan be used, included optical imaging systems. When a structured lightimaging system is used, the image may include a three-dimensional pointcloud representative of a surface topology of the surgical field.Additionally or alternatively, when a structured light imaging system isused, the image may include a three-dimensional point cloudrepresentative of a surface topology and associated spectral properties(e.g., color, brightness) of the surgical field. The image may alsoinclude a mesh representation of the surface topology, such as a polygonmesh where vertices, edges, and faces define the surface topology andassociated spectral properties.

As one example, the image of the surgical field can be obtained using astructured light imaging system such as Einscan Pro hand-held structuredlight scanner (Shining 3D, Hangzhou, China). This device acquires athree-dimensional color image of the target anatomy by projectingpatterned optical light on the target and acquiring and processingbinocular color images of the illuminated target. The imaging systemcan, in general, be offset from the surgical field to permit imageacquisition without violating the sterility of the surgical field. As anexample, the imaging system can be offset by 400 mm.

Registered data are produced by registering the image of the surgicalfield with the pre-operative images, the model of the anatomicregion-of-interest, or both, as indicated at step 610. In this manner,the optical tracker, visible in the image of the surgical field, can beregistered with the anatomic region-of-interest. The registered datagenerally include information pertaining to the mechanical relationshipbetween the optical tracker and the surgical implant or surgical tool towhich the optical tracker was mechanically coupled during imaging, or towhich the surgical implant or surgical tool is mechanically coupledafter the optical tracker has been imaged. As a result, when the imagedepicting the optical tracker is registered to the pre-operative images,the model of the anatomical region-of-interest, or both, informationabout that mechanical relationship is registered with the anatomicalregion-of-interest. Then, based on that mechanical relationship beingregistered with the target anatomy, the spatial relationship of thesurgical implant or surgical tool is defined relative to the anatomicalregion-of-interest. For example, the spatial relationship between thesurgical implant or tool with respect to the anatomicalregion-of-interest can be calculated using the registered data and basedon the mechanical relationship between the optical tracker and thesurgical implant or tool. In these instances, the calculated spatialrelationship can be stored with the other registered data, orseparately.

In general, surface-to-surface registration of the target anatomy (e.g.,the anatomical region-of-interest) from an optical surface image to amodel derived from pre-operative imaging can be improved when theoptical surface of the target anatomical be accurately determined fromthe pre-operative image. When the target anatomy is a joint, such as theshoulder, the surface of the joint visible to the intra-operativeoptical surface imaging system is composed of soft tissues such asarticular cartilage and fibrocartilage. These soft tissues are presentin all healthy shoulders, but may be degraded to a greater or lesserextent in the setting of joint degeneration (e.g., arthritis).

In some examples, the surface of the target anatomy can be accuratelymodeled by segmenting and modeling the target anatomy surface, includingany remaining soft tissues (e.g., articular cartilage andfibrocartilage), from pre-operative imaging that resolves thesestructures (e.g., MRI, MRI arthrography, or CT arthrography).

In some other examples, the surface of the target anatomy can beaccurately modeled by mechanically or chemically debrided soft tissuesprior to obtaining the intra-operative optical surface image. In thisway, the subchondral bone would be visualized directly in the opticalsurface image, such that the pre-operative target anatomy model could bederived from segmentation and modeling the bone of the target anatomy.This would facilitate use of pre-operative imaging systems (e.g., CT)that may not otherwise accurately resolve articular soft tissuestructures.

In some other examples, the surface of the target anatomy can beaccurately modeled by processing the pre-operative images obtained froman imaging system (e.g., CT) that does not accurately resolve these softtissue structures. As an example, this image processing can includeenhancing the pre-operative images so that the soft tissue structurescould be resolved and directly modeled. Additionally or alternatively,this image processing could include inferring the volumes of soft tissuestructures based on the shape and relationship of visualized structures,such as bone and the joint space. Additionally or alternatively, theshape of the articular surface could be inferred from the pre-operativeimages using machine learning techniques.

The registered data can be displayed to a user, as indicated at step612. For instance, the registered data can include one or more displayelements that are generated and displayed as overlays with thepre-operative images, the model of the anatomic region-of-interest, orboth. The display elements can depict the position, orientation, orboth, of the optical tracker, the surgical implant (or other medicaldevice), the guidewire, or combinations thereof. In some instances, theregistered data can also include data representative of an accuracy ofthe position, orientation, or both, of the surgical implant or othermedical device. Based on feedback from these data, the surgeon can finetune or otherwise adjust the position, orientation, or both of thesurgical implant or other medical device, as indicated at step 614. Insome instance, the reorientation tool described in the presentdisclosure can be used to facilitate this adjustment.

As an example, the systems and methods described in the presentdisclosure can be implemented for evaluating the position of the centralglenoid pin intra-operatively during total shoulder arthroplasty, inwhich this guide pin is used to prepare the glenoid for implantation ofthe glenoid component. In this way, evaluating the position of thecentral glenoid pin can determine the orientation of the glenoidcomponent relative to the subject's anatomy (e.g., the scapula). Whenthe central glenoid guide pin is placed, an optical tracker is placedover the guide pin. A structured light imaging system, which may includea hand-held structured light sensor, can then be used to obtain atopographical optical image of the exposed glenoid surface.

Referring now to FIG. 7, an example of a computer vision system 700 forgenerating providing guidance during a surgical procedure (e.g., whenimplanting a surgical implant or other implantable medical device) inaccordance with some embodiments of the systems and methods described inthe present disclosure is shown. The computer vision system 700 displaysthe three-dimensional position of the guide pin, guidewire, or otherlandmark, which guides the surgical implant preparation and determinesthe placement (e.g., the version, inclination, and/or offset) of thesurgical implant. The position of the guide pin, guidewire, or otherlandmark, is displayed with respect to one or more pre-operative images,and optionally a pre-operative plan. The position of the guide pin,guidewire, or other landmark, is registered from the topographicaloptical image of the surgical field, which includes the anatomy ofinterest (e.g., the glenoid surface) and the optical tracker centered atthe guide pin, guidewire, or other landmark. The optical tracker andanatomy of interest are segmented and registered in the reference frameof this single surface image.

As shown in FIG. 7, a computing device 750 can receive one or more typesof image data from image source 702. In some embodiments, computingdevice 750 can execute at least a portion of a surgical guidance system704 to generate registered data for guiding a surgical implant orotherwise verifying a position, orientation, or placement of a surgicalimplant from image data received from the image source 702.

Additionally or alternatively, in some embodiments, the computing device750 can communicate information about image data received from the imagesource 702 to a server 752 over a communication network 754, which canexecute at least a portion of the surgical guidance system 704 togenerate registered data for guiding a surgical implant or otherwiseverifying a position, orientation, or placement of a surgical implantfrom image data received from the image source 702. In such embodiments,the server 752 can return information to the computing device 750(and/or any other suitable computing device) indicative of an output ofthe surgical guidance system 704 to generate registered data for guidinga surgical implant or otherwise verifying a position, orientation, orplacement of a surgical implant from image data received from the imagesource 702.

In some embodiments, computing device 750 and/or server 752 can be anysuitable computing device or combination of devices, such as a desktopcomputer, a laptop computer, a smartphone, a tablet computer, a wearablecomputer, a server computer, a virtual machine being executed by aphysical computing device, and so on. As described above, the surgicalguidance system 704 can register image data with pre-operative images togenerate registered data. The computing device 750 and/or server 752 canalso reconstruct or otherwise images from the image data.

In some embodiments, image source 702 can be any suitable source ofimage data, such as a structured light image system, an optical imagingsystem, an x-ray computed tomography system, a magnetic resonanceimaging system, another computing device (e.g., a server storing imagedata), and so on. In some embodiments, image source 702 can be local tocomputing device 750. For example, image source 702 can be incorporatedwith computing device 750 (e.g., computing device 750 can be configuredas part of a device for capturing, scanning, and/or storing images). Asanother example, image source 702 can be connected to computing device750 by a cable, a direct wireless link, and so on. Additionally oralternatively, in some embodiments, image source 702 can be locatedlocally and/or remotely from computing device 750, and can communicateimage data to computing device 750 (and/or server 752) via acommunication network (e.g., communication network 754).

In some embodiments, communication network 754 can be any suitablecommunication network or combination of communication networks. Forexample, communication network 754 can include a Wi-Fi network (whichcan include one or more wireless routers, one or more switches, etc.), apeer-to-peer network (e.g., a Bluetooth network), a cellular network(e.g., a 3G network, a 4G network, etc., complying with any suitablestandard, such as CD MA, GSM, LTE, LTE Advanced, WiMAX, etc.), a wirednetwork, etc. In some embodiments, communication network 754 can be alocal area network, a wide area network, a public network (e.g., theInternet), a private or semi-private network (e.g., a corporate oruniversity intranet), any other suitable type of network, or anysuitable combination of networks. Communications links shown in FIG. 7can each be any suitable communications link or combination ofcommunications links, such as wired links, fiber optic links, Wi-Filinks, Bluetooth links, cellular links, and so on.

Referring now to FIG. 8, an example of hardware 800 that can be used toimplement image source 702, computing device 750, and server 754 inaccordance with some embodiments of the systems and methods described inthe present disclosure is shown. As shown in FIG. 8, in someembodiments, computing device 750 can include a processor 802, a display804, one or more inputs 806, one or more communication systems 808,and/or memory 810. In some embodiments, processor 802 can be anysuitable hardware processor or combination of processors, such as acentral processing unit (“CPU”), a graphics processing unit (“GPU”), andso on. In some embodiments, display 804 can include any suitable displaydevices, such as a computer monitor, a touchscreen, a television, and soon. In some embodiments, inputs 806 can include any suitable inputdevices and/or sensors that can be used to receive user input, such as akeyboard, a mouse, a touchscreen, a microphone, and so on.

In some embodiments, communications systems 808 can include any suitablehardware, firmware, and/or software for communicating information overcommunication network 754 and/or any other suitable communicationnetworks. For example, communications systems 808 can include one ormore transceivers, one or more communication chips and/or chip sets, andso on. In a more particular example, communications systems 808 caninclude hardware, firmware and/or software that can be used to establisha Wi-Fi connection, a Bluetooth connection, a cellular connection, anEthernet connection, and so on.

In some embodiments, memory 810 can include any suitable storage deviceor devices that can be used to store instructions, values, etc., thatcan be used, for example, by processor 802 to present content usingdisplay 804, to communicate with server 752 via communications system(s)808, etc. Memory 810 can include any suitable volatile memory,non-volatile memory, storage, or any suitable combination thereof. Forexample, memory 810 can include RAM, ROM, EEPROM, one or more flashdrives, one or more hard disks, one or more solid state drives, one ormore optical drives, etc. In some embodiments, memory 810 can haveencoded thereon a computer program for controlling operation ofcomputing device 750. In such embodiments, processor 802 can execute atleast a portion of the computer program to present content (e.g.,ultrasound images, user interfaces, graphics, tables, etc.), receivecontent from server 752, transmit information to server 752, etc.

In some embodiments, server 752 can include a processor 812, a display814, one or more inputs 816, one or more communications systems 818,and/or memory 820. In some embodiments, processor 812 can be anysuitable hardware processor or combination of processors, such as a CPU,a GPU, etc. In some embodiments, display 814 can include any suitabledisplay devices, such as a computer monitor, a touchscreen, atelevision, etc. In some embodiments, inputs 816 can include anysuitable input devices and/or sensors that can be used to receive userinput, such as a keyboard, a mouse, a touchscreen, a microphone, etc.

In some embodiments, communications systems 818 can include any suitablehardware, firmware, and/or software for communicating information overcommunication network 754 and/or any other suitable communicationnetworks. For example, communications systems 818 can include one ormore transceivers, one or more communication chips and/or chip sets,etc. In a more particular example, communications systems 818 caninclude hardware, firmware and/or software that can be used to establisha Wi-Fi connection, a Bluetooth connection, a cellular connection, anEthernet connection, etc.

In some embodiments, memory 820 can include any suitable storage deviceor devices that can be used to store instructions, values, etc., thatcan be used, for example, by processor 812 to present content usingdisplay 814, to communicate with one or more computing devices 750, etc.Memory 820 can include any suitable volatile memory, non-volatilememory, storage, or any suitable combination thereof. For example,memory 820 can include RAM, ROM, EEPROM, one or more flash drives, oneor more hard disks, one or more solid state drives, one or more opticaldrives, etc. In some embodiments, memory 820 can have encoded thereon aserver program for controlling operation of server 752. In suchembodiments, processor 812 can execute at least a portion of the serverprogram to transmit information and/or content (e.g., generatedadditional ultrasound data, ultrasound images, a user interface, etc.)to one or more computing devices 750, receive information and/or contentfrom one or more computing devices 750, receive instructions from one ormore devices (e.g., a personal computer, a laptop computer, a tabletcomputer, a smartphone, etc.), etc.

In some embodiments, image source 702 can include a processor 822, animaging system 824, one or more communications systems 826, and/ormemory 828. In some embodiments, processor 822 can be any suitablehardware processor or combination of processors, such as a CPU, a GPU,etc. In some embodiments, imaging system 824 can be any suitable imagingsystem configured to acquire images. As one example, the imaging system824 can be a structured light imaging system. Additionally oralternatively, in some embodiments, imaging system 824 can include anysuitable hardware, firmware, and/or software for coupling to and/orcontrolling operations of an imaging system. In some embodiments, one ormore portions of imaging system 824 can be removable and/or replaceable.

Note that, although not shown, image source 702 can include any suitableinputs and/or outputs. For example, image source 702 can include inputdevices and/or sensors that can be used to receive user input, such as akeyboard, a mouse, a touchscreen, a microphone, a trackpad, a trackball,etc. As another example, image source 702 can include any suitabledisplay devices, such as a computer monitor, a touchscreen, atelevision, etc., one or more speakers, etc.

In some embodiments, communications systems 826 can include any suitablehardware, firmware, and/or software for communicating information tocomputing device 750 (and, in some embodiments, over communicationnetwork 754 and/or any other suitable communication networks). Forexample, communications systems 826 can include one or moretransceivers, one or more communication chips and/or chip sets, etc. Ina more particular example, communications systems 826 can includehardware, firmware and/or software that can be used to establish a wiredconnection using any suitable port and/or communication standard (e.g.,VGA, DVI video, USB, RS-232, etc.), Wi-Fi connection, a Bluetoothconnection, a cellular connection, an Ethernet connection, etc.

In some embodiments, memory 828 can include any suitable storage deviceor devices that can be used to store instructions, values, image data,etc., that can be used, for example, by processor 822 to control imagingsystem 824, and/or receive image data from imaging system 824; togenerate images from data, generated registered data, or combinationsthereof; present content (e.g., images, registered data, displayelements, a user interface, etc.) using a display; communicate with oneor more computing devices 750; and so on. Memory 828 can include anysuitable volatile memory, non-volatile memory, storage, or any suitablecombination thereof. For example, memory 828 can include RAM, ROM,EEPROM, one or more flash drives, one or more hard disks, one or moresolid state drives, one or more optical drives, etc. In someembodiments, memory 828 can have encoded thereon a program forcontrolling operation of image source 702. In such embodiments,processor 822 can execute at least a portion of the program to generateimages, transmit information and/or content (e.g., data) to one or morecomputing devices 750, receive information and/or content from one ormore computing devices 750, receive instructions from one or moredevices (e.g., a personal computer, a laptop computer, a tabletcomputer, a smartphone, etc.), etc.

In some embodiments, any suitable computer readable media can be usedfor storing instructions for performing the functions and/or processesdescribed herein. For example, in some embodiments, computer readablemedia can be transitory or non-transitory. For example, non-transitorycomputer readable media can include media such as magnetic media (e.g.,hard disks, floppy disks), optical media (e.g., compact discs, digitalvideo discs, Blu-ray discs), semiconductor media (e.g., random accessmemory (“RAM”), flash memory, electrically programmable read only memory(“EPROM”), electrically erasable programmable read only memory(“EEPROM”)), any suitable media that is not fleeting or devoid of anysemblance of permanence during transmission, and/or any suitabletangible media. As another example, transitory computer readable mediacan include signals on networks, in wires, conductors, optical fibers,circuits, or any suitable media that is fleeting and devoid of anysemblance of permanence during transmission, and/or any suitableintangible media.

The present disclosure has described one or more preferred embodiments,and it should be appreciated that many equivalents, alternatives,variations, and modifications, aside from those expressly stated, arepossible and within the scope of the invention.

1-7. (canceled)
 8. An optical tracker, comprising: a base composed of abiocompatible material and extending from a proximal surface to a distalsurface along a central axis; a channel formed in the base and extendingfrom the proximal surface of the base to the distal surface of the basealong the central axis, wherein channel is sized and shaped to receiveone of a guide pin or a guidewire.
 9. The optical tracker as recited inclaim 8, wherein the base is composed of a material that is colored inorder to provide visual contrast with a surgical field in an imageacquired with a structured light imaging system.
 10. The optical trackeras recited in claim 9, wherein the material of the base is colored atleast one of gray or blue in order to provide the visual contrast withthe surgical field.
 11. The optical tracker as recited in claim 8,wherein the base comprises a first portion having a first outer diameterand a second portion that tapers from the first outer diameter to asecond outer diameter that is smaller than the first outer diameter. 12.The optical tracker as recited in claim 11, wherein the second portionof the base defines a leading surface of the optical tracker.
 13. Theoptical tracker as recited in claim 8, wherein the base is radiallysymmetric about the central axis.
 14. A kit, comprising: an opticaltracker comprising: a base composed of a biocompatible material andextending from a proximal surface to a distal surface along a centralaxis; a channel formed in the base and extending from the proximalsurface of the base to the distal surface of the base along the centralaxis, wherein channel is sized and shaped to receive one of a guide pinor a guidewire; a reorientation tool comprising: a fiducial partcomprising an annular base having a central aperture in which a notch isformed; a key part sized and shaped to be received by the centralaperture of the fiducial part, the key part comprising an annular basehaving a central aperture, wherein a catch is formed on an outer surfaceof the annular base of the key part, wherein the catch is sized andshaped to operative engage the notch formed in the central aperture ofthe fiducial part; one or more interchangeable insert parts, each insertpart comprising a cylindrical base that is sized and shaped to bereceived by the central aperture of the key part, wherein each insertpart comprises at least one channel that defines a trajectory having aunique polar angle, wherein each insert part is rotatable within thecentral aperture of the key part to define a unique azimuthal angle. 15.The kit as recited in claim 14, wherein the biocompatible material ofthe base of the optical tracker is colored in order to provide visualcontrast with a surgical field in an image acquired with a structuredlight imaging system.
 16. The kit as recited in claim 14, wherein thebase of the optical tracker comprises a first portion having a firstouter diameter and a second portion that tapers from the first outerdiameter to a second outer diameter that is smaller than the first outerdiameter.
 17. The kit as recited in claim 14, wherein the base of theoptical tracker is radially symmetric about the central axis.